Accoding to this paper, which looks at the link between teenage conceptions and deprivation, in 2004:

the most deprived 20 per cent of local authorities in England had, on average, an under 18 conception rate of 56 conceptions per 1,000 females aged 15–17, compared to 25 per 1,000 in the 20 per cent least deprived

This is important because its a clear driver of health and other inequality:

Teenage mothers are less likely to finish their education; are more likely to bring up their child alone and in poverty and have a higher risk of poor mental health than older mothers. Infant mortality rates for babies born to teenage mothers are around 60 per cent higher than for babies born to older mothers. The children of teenage mothers have an increased risk of living in poverty and poor quality housing and are more likely to have accidents and behavioural problems.

But, as you would expect with something as complex as this, living in a deprived area isn’t the whole story. The paper goes on to cite research which found:

that while social deprivation indices are useful measures, the explanation of higher teenage pregnancy rates in deprived areas is multifactorial, and includes personal factors such as low self-esteem, lower educational and occupational aspirations, less knowledge of contraception and sexual health services and higher gender power differentials.

There are other risk factors as well such as being the son or daughter of a teenage parent, and when young people face multiple risk factors this intesifies the chances of their becoming a teenage parent.

The paper goes on to look at just how different the rates of conception and abortion are between the most and least deprived areas and concludes:

Overall, low conception rates and high abortion proportions in the least deprived areas compared with high conception rates and low abortion proportions in the most deprived areas mean that rates of teenage maternities resulting from under 18 conceptions are around ten times higher between the most and least deprived areas. An even steeper gradient was observed for the under 16 conceptions.

So, what’s been going on in Lewisham.

The ONS suggests that Lewisham’s teenage conception rate has been consistently higher than the London and national average. And after a dip there has been a return to higher levels of conceptions. (It’s still 6 fewer conceptions per 1000 than in 1998, where as the London average has stayed almost constant.)

As you’ll see the figures stop in 2003 and as the PCT website is going through a bit of a overhaul and doesn’t have public health data that is all that recent either.

I did, however, see the 2004 draft strategy document which sets out how the PCT will try and reduce health inequalities has a few specific targets on teenage conceptions:

Local Strategic Partnership Target: By 2010, to reduce the conception rate among under 18s in the worst quintile of wards by at least 60%, thereby reducing the level of inequality between the worst quintile and the average by at least 26% by 2010.

Proposed Local Public Service Agreement Target: By 2007, to reduce, by 50% the 2002 Lewisham under 18 teenage conception rate in young women (under 18 years), thereby contributing to the overall reduction of under 18 conception rates in Lewisham and the UK

And this take on health in the borough makes it clear that teenage parenthood is no bed of roses:

Out of all the young mothers in Lewisham in 2002, 76% were lone parents, 36% had no qualifications and 33% were non-white (of these the largest minority group was Black Caribbean), 9% were mixed race and 58% were white.

But, what are we to make of this from the same document:

The 2003 ward data showed that high rates of under 18 year conceptions were evident through Lewisham and not particularly associated with deprived wards, although there is local anecdotal information that high rates are associated with deprived estates and certain schools in Lewisham.